An Episcopal (Anglican) Chaplain in the Saint Luke's Health System of Kansas City, reflecting on work and faith and life. NOTA BENE: my opinions are my own and do not represent the Episcopal Church or the Saint Luke's Health System.

Sunday, June 19, 2016

Credit Where Credit Is Due

The Healthcare Chaplaincy Network (HCCN) has disturbed the chaplaincy profession with the decision to establish the Spiritual Care Association (SCA). While I don't think it was necessary, my position is basically that of Gamaliel in the Acts of the Apostles. I plan not to say too much about it, and trust in God. If it brings benefits it will stand. If it doesn't, it will fail without help from anyone else.

With all the criticism, though, of HCCN for starting a new organization, I think there is some point in appreciating other things that they have contributed. They have provided support for a number of projects. They have been especially interested in research. HCCN leadership has felt that, to the extent possible, the profession should be evidence-based, and research is how we get the evidence.

Not that I'm going to do that here - at least, not in full. The document is 88 pages, with a great deal of information to digest. So, I'm not going to do single review of the entire piece. I am, however, going to look at some interesting parts of it.

I am going to recommend that we all read the first section of the paper, the Executive Summary. There is plenty of information there to consider. There is a summary review of chaplaincy in healthcare, and an argument that chaplaincy should be research-based.

Also helpful, and especially helpful to include in the Executive Summary is Gap Analysis, a list of areas for research that would benefit the profession. The list itself is both exciting and appalling: it is both excitingly thorough and depressingly long. We have a lot of work to think about doing.

I happen to agree that our profession can and should do research. However, my concern is that we're not doing research that could benefit us. As the Executive Summary states,

Since chaplaincy research has only begun to accumulate, there is a significant danger that research will not proceed in a focused and organized manner.

We're not alone in that. In this recent story on NPR it was observed that in many fields that's an issue. There is excitement over the new and groundbreaking, but not much over confirming (or disproving) something already started.

For chaplains, at least, this has resulted in a host of small studies, essentially pilot studies that demonstrate (if they demonstrate anything) that a subject can be studied, and that perhaps there is value in studying it again. And if no one actually studies it again, the potential value is lost. So, the authors point out,

If study questions, methods and outcomes are carefully chosen they will build upon and integrate with other work in the field of spiritual care. One way to support a focused research agenda is to fund research through one or more central consortia, which would set the research agenda, fund studies through a Request for Proposals process, and promote communication and capacity building among the research groups. The consortium would be advised by clinical and research leaders in chaplaincy who would set the basic parameters of the research, monitor its progress, and serve as mentors to new researchers.

This is certainly an issue that the professional organizations, and larger chaplaincy institutions (like HCCN) might take up, whether individually or as part of a proposed consortium: choosing topics for study, or replicating worthwhile pilot studies, on a large, even multicenter scale. We might even be able to leverage recent changes in healthcare in general to support that. For example, a number of centers using the same electronic medical record platform might add specific pieces to their documentation. That would allow consistency and ease of access to the data across a variety of institutions. Such a proposed consortium, or even a single body adept at coordination and grant writing, could help make these meaningful steps.

The paper, Literature Review - Testing the Efficacy of Chaplaincy Care, from HCCN is a significant contribution to the field, one that many may have missed. I think all of us should review at least the Executive Summary. Those of us with a more active interest in research should dig further (and, after all, for those of us whose continuing education requirements include some focus on research, there are several contact hours to be acquired here, covering the good work). While HCCN has become a center of controversy, we also do not want to ignore their important contributions, including this one.

Larry, I don't think collaboration is out of the question. However, if you have watched the video or read the comments of the Eric Hall, President and CEO of HCCN, you can make your own assessment of whether he was going to "win friends and influence people."

I do think there has been work coming out of HCCN, like the paper cited, that is worth noting. I think - I hope - we can separate those from the issue of SCA. As long as those resources are available (not behind a membership or pay wall, for example), we can, as I put in the title, give "credit where due" - at least to the folks who did the work, however we might feel about the "publisher."